Embolismo paradójico intraoperatorio en paciente con síndrome de Eisenmenger sometida a hemiartroplastia de cadera / Paradoxical intraoperative embolism in a patient with Eisenmenger syndrome undergoing hip arthroplasty

La artroplastia de cadera se asocia a una elevada incidencia de eventos embólicos que, si bien normalmente no tienen trascendencia a nivel clínico, pueden suponer una causa importante de morbimortalidad en determinadas situaciones. En el caso de pacientes con defectos cardiacos que favorezcan la comunicación entre la circulación pulmonar y la sistémica, deberemos extremar toda precaución, puesto que presentan un gran riesgo de sufrir complicaciones. Exponemos el caso de una paciente de 72 años que sufrió un embolismo paradójico durante la realización de la intervención, con devastadoras consecuencias

Hip arthroplasty is associated with a high incidence of embolic events that, although usually not relevant at a clinical level, may be an important cause of morbidity and mortality in certain situations. Extreme caution should be taken in patients with cardiac defects that favor communication between the pulmonary and systemic circulation, due to their greater risk of complications. We present the case of a 72-year-old patient who suffered a paradoxical embolism during the intervention, with devastating consequences

Paradoxical intraoperative embolism in a patient with Eisenmenger syndrome undergoing hip arthroplasty. / Embolismo paradójico intraoperatorio en paciente con síndrome de Eisenmenger sometida a hemiartroplastia de cadera.

Hip arthroplasty is associated with a high incidence of embolic events that, although usually not relevant at a clinical level, may be an important cause of morbidity and mortality in certain situations. Extreme caution should be taken in patients with cardiac defects that favor communication between the pulmonary and systemic circulation, due to their greater risk of complications. We present the case of a 72-year-old patient who suffered a paradoxical embolism during the intervention, with devastating consequences.

Effect of kaolin silver complex on the control of populations of Brettanomyces and acetic acid bacteria in wine.

In this work, the effects of kaolin silver complex (KAgC) have been evaluated to replace the use of SO2 for the control of spoilage microorganisms in the winemaking process. The results showed that KAgC at a dose of 1 g/L provided effective control against the development of B. bruxellensis and acetic acid bacteria. In wines artificially contaminated with an initial population of B. bruxellensis at 104 CFU/mL, a concentration proven to produce off flavors in wine, only residual populations of the contaminating yeast remained after 24 days of contact with the additive. Populations of acetic bacteria inoculated into wine at concentrations of 102 and 104 CFU/mL were reduced to negligible levels after 72 h of treatment with KAgC. The antimicrobial effect of KAgC against B. bruxellensis and acetic bacteria was also demonstrated in a wine naturally contaminated by these microorganisms, decreasing their population in a similar way to a chitosan treatment. Related to this effect, wines with KAgC showed lower concentrations of acetic acid and 4-ethyl phenol than wines without KAgC. The silver concentration from KAgC that remained in the finished wines was below the legal limits. These results demonstrated the effectiveness of KAgC to reduce spoilage microorganisms in winemaking.

Patrones de infección asociada a los cuidados de salud en el paciente crítico postquirúrgico. Análisis prospectivo multivariante en una cohorte de pacientes / Patterns of healthcare-associated infections in postsurgical critical patients. Prospective multivariate analysis in a cohort of patients

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Crisis económica española y salud. Impacto clínico en el dolor crónico / Economic crisis and health in Spain. Clinical impact in chronic pain

Antecedentes: múltiples gobiernos europeos han reducido de forma considerable el gasto público en salud durante la crisis económica. Las posibles consecuencias de la crisis financiera sobre los resultados en la salud han comenzado a aparecer. La recesión también ha impulsado diversas reformas estructurales que han afectado a la prioridad otorgada a las políticas públicas. El propósito de este trabajo es analizar el posible impacto de las políticas de austeridad en la salud en España, y así entender la respuesta de los sistemas sanitarios europeos a la crisis financiera y políticas de austeridad. Material y métodos: estudio prospectivo de 206 pacientes en una Unidad de Dolor Crónico durante un periodo de dos años. Se evaluaron los tratamientos farmacológicos, invasivos y los resultados médicos de la unidad en función del nivel de ingresos del paciente. Resultados: la situación económica del paciente se correlacionó de forma estadísticamente significativa con el éxito del tratamiento médico (p = 0,01), así como en la aparición de diversos efectos adversos en relación al tratamiento médico (p < 0,01). Existe una fuerte evidencia de un efecto negativo estadísticamente significativo de la actual crisis financiera sobre los resultados de sanitarios. Conclusiones: las decisiones políticas y su respuesta a las crisis económicas han acentuado los efectos no deseados sobre la salud pública. El gobierno y los diversos líderes deben hallar fórmulas eficientes para mitigar sus efectos (AU)

Background: Many European governments have abundantly cut down public expenditure on health during the financial crisis. Consequences of the financial downturn on health outcomes have begun to emerge. The recession has also driven structural reforms, and affected the priority given to public policies. The purpose of this paper is to analyse how austerity impacts health in Spain and better understand the response of European health systems to the financial crisis. Material and methods: Prospective study of 206 patients over a period of two years. Was evaluated various pharmacological and invasive treatments and medical outcomes in Chronic Pain Unit depending on the patient’s income level. Results: The economic situation of the patient is statistically significantly correlated with the success of medical treatment (p = 0.01) and the occurrence of various adverse effects in relation to medical treatment (p < 0.01). Results provide strong evidence of a statistically significant negative effect of the financial crisis on health trends. Conclusions: Policy decisions about how to respond to economic crises have pronounced and unintended effects on public health. The governance and leadership find ways to mitigate its effects (AU)

[Smoking habits: a study of hospital staff]. / Hábitos tabáquicos: estudio en personal hospitalario.

The results of a survey carried out in our hospital about the use of cigarettes in which 680 staff members participated (257 men and 423 women) are presented. The percentage of current smokers was 50% (51.8% amongst women and 45.1% amongst men). The highest percentages of smokers were found amongst nurses (61%), maintenance staff (50%) and administrative staff (45.1%); 41% of physicians smoked. Quitting the smoking habit was more frequent amongst physicians and higher grade staff, with a predominance of older males. The smallest number of quitters was found amongst nurses. 93.5% of the surveyed subjects agreed with the establishment of restrictive measures, finding no differences according to age, sex, or professional status, although there were differences according to the smoking habit. The results obtained point out the importance of the smoking problem amongst health professionals and could be used to promote programs against smoking in hospitals.